COMPARATIVE STUDY OF VAGINAL VERSUS INTRAMUSCULAR PROGESTERONE IN THE PREVENTION OF PRETERM DELIVERY

Alaa Fawaz Muanna*, PhD. Ahmad Ali Abdulrahman and PhD. Thawra Naiseh

ABSTRACT

Background: Preterm birth is a worldwide health concern due to its various negative consequences. Therefore, the
prevention of preterm birth is a top priority for healthcare systems in all countries. Objective: To compare the
effectiveness of vaginal versus intramuscular progesterone in the prevention of preterm delivery. Methods: This
randomized clinical trial was conducted at Tishreen university, within the period from April 2023 to May 2024.
120 pregnant women with singleton pregnancy and one risk factor of preterm delivery were included in the study.
They were then randomly allocated into Vaginal progesterone group (n=60) and intramuscular progesterone (17α-
hydroxyprogesterone caproate) group (n=60). Subsequently, we analyzed drug complications during pregnancy,
delivery time, neonatal outcomes, and the side effects on patients in the two groups. The Pearson chi-square and
Student’s t test were used to compare two groups and IBM SPSS statistics Version 25 for the analysis of primary
and secondary outcomes. Results: Among the 60 births in group one (Vaginal Progesterone), 30% occurred
preterm, and, among the 60 births in group two (intramuscular Progesterone), 30% occurred preterm (< 37 weeks).
The mean gestational ages at delivery in groups 1 and 2 were 37.3 ±1.1 and 37.16±1.3 weeks, respectively
(p>0.05). Other variables were not significantly different between the two groups, including length of stay in the
hospital when the newborns needed hospitalization (p=0.3), and the side effects on patients (p<0.05). Conclusions:
In this study, vaginal progesterone and intramuscular progesterone had the same levels of effectiveness in the
prevention of preterm delivery. Therefore, both can be used for this purpose in clinical practices, the frequency of
side effects was slightly higher in the intramuscular progesterone group when compared to the vaginal
progesterone group, but more studies are needed to confirm this result or modify it.

Keywords: Preterm labor, Preterm birth, Vaginal progesterone, Intramuscular progesterone.